Impact of electromagnetic field exposure on reproductive health: an umbrella review and meta-analysis of systematic reviews

Abstract Background The ubiquitous presence of electromagnetic fields (EMFs), including low-frequency (LF-EMFs) and radiofrequency fields (RF-EMR), has raised concerns regarding their potential effects on reproductive health. EMF exposure has been linked to adverse outcomes such as reduced sperm quality, hormonal disruption, and negative pregnancy outcomes. However, inconsistent findings and methodological variability necessitate a comprehensive synthesis of evidence. Objective To evaluate the impact of EMF exposure on reproductive health by consolidating findings from systematic reviews and meta-analyses. Methods A systematic literature search was conducted in PUBMED and SCOPUS for systematic reviews and meta-analyses published between 2014 and 2024. Eligible studies assessed human reproductive outcomes, including sperm quality, hormone levels, and pregnancy outcomes, in relation to LF-EMFs or RF-EMR exposure. Data were extracted and synthesized qualitatively and quantitatively using a random-effects model. Sensitivity analyses assessed the robustness of the findings. Results Nine systematic reviews encompassing 215 primary studies were included. RF-EMR exposure significantly reduced sperm motility (mean difference [MD]: -3.90; 95% CI: -6.20, -1.60) and viability (MD: -2.85; 95% CI: -4.50, -1.20). Oxidative stress, evidenced by elevated reactive oxygen species and DNA damage, emerged as a key mechanism. Testosterone levels were significantly reduced (MD: -1.5 ng/dL; 95% CI: -2.3, -0.7), while evidence on follicle-stimulating hormone (FSH) and luteinizing hormone (LH) was inconsistent. Occupational exposure was associated with increased risks of miscarriage and congenital anomalies. Conclusion EMF exposure adversely affects reproductive health, particularly sperm quality and hormonal balance, with oxidative stress serving as a plausible mechanism. Public health strategies should prioritize exposure mitigation.